摘要
目的探讨抗线粒体抗体2型、4型、9型(AMA-M2、M4、M9)在原发性胆汁性胆管炎(PBC)中的分布及临床意义。方法分析2014年1月至2019年12月北京协和医院检测的AMA亚型(M2、M4、M9)的1367例患者临床资料。分析AMA亚型在不同年龄、性别组的分布及各亚型在PBC诊断中的特异度及灵敏度,并对非PBC且AMA亚型阳性的患者诊断进行分析。无序分类变量使用χ^(2)检验,计量资料以M±SD表示。结果在1367例患者中AMA亚型阳性为236例,其中,男性AMA亚型阳性率为9.41%(37例),女性为20.43%(199例),二者差异有统计学意义(χ^(2)=23.792,P<0.01)。AMA阳性患者主要分布在30~65岁(193/965,占20.00%),7~29岁(17/155,占10.97%),66~91岁(26/247,占10.53%),不同年龄组间差异有统计学意义(χ^(2)=17.209,P<0.01)。在236例AMA亚型阳性患者中,PBC为110例,分别计算各亚型在PBC中的特异度及灵敏度得出:AMA-M2灵敏度最高[94.64%(106/112)],同时特异度也较高[92.35%(1159/1255)];AMA-M4特异度最高[99.12%(1244/1255)],灵敏度不佳[15.18%(17/112)];联合检测各亚型灵敏度及特异度性没有明显提高。其他疾病亦可出现AMA亚型阳性,且以AMA-M2为主。结论AMA亚型阳性患者以女性为主,主要分布在30~65岁。AMA-M2在各亚型中特异度、灵敏度均较高,对PBC最具诊断价值。
Objective To investigate the distribution and clinical significance of subtypes of antimitochondrial antibodies(AMA)-M2,M4,M9 in primary biliary cholangitis(PBC).Methods A total of 1367 patients were detected with AMA-M2,M4,M9 in Peking Union Medical College Hospital(PUMCH)from Jan 2014 to Dec 2019 and the clinical parameters were collected.The distribution patterns of AMA subtypes in different groups were analyzed and the diagnostic sensitivity and specificity of AMA subtypes in PBC were calculated.Chi-square test was used for statistical analysis.Results In 1367 patients,236 of whom were positive for AMA subtypes.The positivity of AMA subtypes in female was significantly higher than in male(20.34%vs 9.41%,χ^(2)=23.792,P<0.01).In addition,the positivity of AMA subtypes was significantly higher in 30-65 years old patients than in patients younger than 30 years old or older than 65 years old[20.00%(193/965)vs 10.97%(17/155)vs 10.53%(26/247),χ^(2)=17.209,P<0.01].110 patients with positive AMA subtypes were diagnosed with PBC.The diagnostic sensitivity and specificity of AMA-M2 were both desirable[94.64%(106/112)and 92.35%(1159/1255)].Although the specificity of AMA-M4 was as high as 99.12%(1244/1255),its sensitivity was very low[15.18%(17/122)].Combined detection of different AMA subtypes could not improve the diagnostic sensitivity and specificity significantly.Diseases other than PBC can be positive for AMA subtypes,predominantly for AMA-M2.Conclusion Female and 30-65 years old patients were more frequently positive for AMA subtypes.AMA-M2 was the most valuable AMA subtype for diagnosing PBC.
作者
杨红艳
赵丽伶
张蜀澜
胡朝军
曾小峰
张奉春
Yang Hongyan;Zhao Liling;Zhang Shulan;Hu Zhaojun;Zeng Xiaofeng;Zhang Fengchun(Department of Rheumatology and Clinical Immunology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences(the Ministy of Education Key Laborary,National Clinical Research Center for Dermatologic and Immunologic Diseases),Beijing 100730,China;Department of Rheumatic Immunology,Tsinghua Changgung Hospital,Tsinghua University School of Medicine,Beijing 202218,China;the Department of Heumatology and Rheumatology,Qinghai Provincial People's Hospital,Xining 810007,China)
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2021年第8期525-528,共4页
Chinese Journal of Rheumatology
基金
国家自然科学基金(81771764)
国家重点研发项目(2016YFA0101003)。
关键词
胆管炎
抗线粒体抗体
蛋白质亚型
Cholangitis
Antimitochondrial antibody
Protein Isoforms
